The benefits and disappointments following clitoral reconstruction after female genital cutting: A qualitative interview study from Sweden

Abstract

Female genital cutting or mutilation refers to the cutting of girls’ external genitalia. Due to migration from contexts where female genital cutting is common, it is estimated that around 38 000 cut women and girls live in Sweden. Clitoral reconstruction, a relatively new form of surgical healthcare offered to women with female genital cutting, was established in Sweden in 2014. This surgery aims at restoring clitoral function and anatomy, but there is yet a dearth of evidence demonstrating the effects of the surgery. The aim of this study was to explore how women undergoing clitoral reconstruction in Sweden between 2016 and 2019 experienced the surgical process and its aftereffects from a physical, sexual and psychosocial perspective. Eighteen women who had undergone clitoral reconstruction at a university hospital in Sweden agreed to participate in the study. The women were interviewed using semi-structured interviews, which were recorded, transcribed and analysed using thematic analysis. The results, based on self-categorization and labelling theory, demonstrated both benefits and disappointments following the surgery. Several women reported positive outcomes in terms of sexual, psychosocial and aesthetic terms. They experienced reduced genital pain, improvements in their sex lives, and a sense of feeling more empowered and at ease in their bodies. Yet, some women reported aesthetic, functional and process-related disappointment related to clitoral reconstruction. Nonetheless, the women expressed gratitude for the possibility of undergoing the surgery. In conclusion, the women reported that they experienced physical, sexual and psychosocial benefits of the surgery.

Clitoral reconstruction: challenges and new directions

“…A further qualitative study was carried out by Jordal and colleagues [77] between 2016 and 2019 among 18 women from sub-Saharan origins, living in Sweden and who had undergone CR. The study, which explored the women's level of satisfaction in relation to the CR and the changes that surgery brought, had the merit of showing that CR has the impact of reducing or eliminating feelings of stigmatisation, which is the principal result.…”

Examining the key features of specialist health service provision for women with Female Genital Mutilation/Cutting (FGM/C) in the Global North: a scoping review

“…The Bicetre, France service calls itself a “care unit for women with FGM/C” ( 59 ). The Karolinska university hospital, Sweden “ receives referrals from a specialist clinic” ( 64 ). The Manero, Spanish service is a “ single centre with a dedicated surgical team” ( 66 ) and the paper describing the service in Italy refers to “ a regional project for FGM/C and women immigrants” ( 71 ).…”

“…Three services ( 60 , 65 , 79 ) offered labial as well as clitoral reconstruction. Jordal et al ( 64 ) recommended a 2 step process of deinfibulation followed by reconstruction (this is likely to be because women might, after deinfibulation, no longer want reconstruction surgery). Jordal (Karolinska, Sweden) pointed out that women wanted labial reconstruction (as well as clitoral), but this was not available ( 64 ).…”

Surgical Healthcare Interventions after Female Genital Mutilation/Cutting—A Review of the Evidence

“…This could be seen as a valid point, as surgery is always risky. However, suggesting therapy for something that is perceived as a physical violation has been strongly criticized by women seeking and undergoing CR [61]. While sexual education and counseling might well be a solution to FGM/C-affected women's sexual problems and should indeed be available, this may not be everyone's preference.…”